BMC primary care最新文献

{"title":"Shift in therapeutic approaches in patients with hypercholesterolemia - a secondary data analysis.","authors":"Elena Zink, Jost Steinhäuser, Paul-Georg Blickle, Wolfgang C G von Meißner, Christoph Strumann","doi":"10.1186/s12875-025-02982-z","DOIUrl":"10.1186/s12875-025-02982-z","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease is a leading cause of death and hypercholesterolemia is one relevant risk factor. There are two established guidelines for the management of high cholesterol in general practice in Germany, one of these is from the European Society of Cardiology (ESC). This analysis examines whether treatment modalities and clinical outcomes in German primary care have changed after the publication of the 2019 ESC (European Society of Cardiology)/EAS (European Atherosclerosis Society) guidelines on dyslipidaemia.</p><p><strong>Methods: </strong>A retrospective cohort study (2001-2023) with data extracted from electronic health record systems of 17 primary care practices. The Data was used to compare drug treatment and outcomes before and after 2019, the year of the ESC guideline publication. Multilevel regression analysis was used to assess the effects of the new guidelines, accounting for time trends and patient- and practice-level factors.</p><p><strong>Results: </strong>Statin prescriptions for 23,322 patients with hypercholesterolemia increased from 6% in 2001 to 27% in 2023, with an increase in treatment intensity after 2012. Despite general reductions in total and LDL cholesterol, cardiovascular events remained unchanged, while reported complaints associated with side effects increased. Multilevel regression showed more prescriptions after the new ESC/EAS guidelines, with no effect on treatment intensity or outcomes.</p><p><strong>Conclusion: </strong>Following the publication of the new ESC/EAS guideline, a modest rise in statin prescriptions has been documented. However, despite improved lipid profiles, clinically relevant events did not decrease yet, and side effects increased, questioning the benefit of tailoring statin therapy to lower lipid thresholds in real world data so far.</p><p><strong>Trial registration: </strong>German Clinical Trials Register: DRKS00032936. Registration Date: October 30, 2023.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"287"},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance evaluation of a point of care capillary blood test for C-reactive protein in community healthcare.","authors":"Matthew Atkins, Kirsty Bartlett, Karen Marriott, Debbie Plant, Sarah Measures, Clarisse Lagman, Christina Newbould, Pete McGrane, Emma Leaver","doi":"10.1186/s12875-025-02972-1","DOIUrl":"10.1186/s12875-025-02972-1","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"288"},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between coping of the primary caregiver and the adolescent patient with cancer.","authors":"Jaramillo Villanueva Leonel, Mario Enrique Rendón Macías, Ana Ríos Covian","doi":"10.1186/s12875-025-02965-0","DOIUrl":"10.1186/s12875-025-02965-0","url":null,"abstract":"<p><strong>Background: </strong>Coping mechanisms help individuals face adversity, remain stable over time, and can be generalized to various circumstances. Two types are typically distinguished: the active style, aimed at resolving problems, and the passive style, focused on emotional regulation. We hypothesized that passive coping of the primary caregiver (hereafter, primary caregiver [PC]) would affect the adaptive coping of his or her adolescent child with cancer (hereafter, adolescent with cancer [AC]).</p><p><strong>Objective: </strong>To analyze coping styles in adolescents with cancer (ACs) and their primary caregivers (PCs).</p><p><strong>Materials and methods: </strong>This was an analytical cross-sectional study including 116 pairs of an adolescent with cancer (AC) and a primary caregiver (PC). The adolescents completed the Adolescent Coping Scale (ACS), applicable to those aged 9-17 years, while the caregivers completed the Coping Strategies Inventory (CSI).</p><p><strong>Results: </strong>49% (57/116) of the pairs both used the active coping style, and 14% showed the passive style in both members. No agreement was found between the coping styles of the AC and PC (Kappa = 0.15, 95% confidence interval [CI]: 0.13-0.14, p = 0.13). The multivariate analysis explained 61% of the variance (Nagelkerke pseudo R2 = 0.61; likelihood ratio = 191.4; p = 0.003).</p><p><strong>Conclusions: </strong>Passive coping by the primary caregiver occurred with low frequency, and active coping was favored, similar to that of the adolescent with cancer.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"286"},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating and sustaining enabling systems and communities to address social needs: protocol for a living lab social prescribing study.","authors":"Candice Oster, Ashleigh Powell, Claire Hutchinson, Sahar Faghidno, Svetlana Bogomolova","doi":"10.1186/s12875-025-02993-w","DOIUrl":"10.1186/s12875-025-02993-w","url":null,"abstract":"<p><strong>Background: </strong>Social needs - such as housing, income, food security, and social connectedness - have a significant effect on health and wellbeing. One way to address social needs is through social prescribing, which involves screening for unmet needs (e.g., during healthcare appointments) and providing referrals to social and community services. For social prescribing to be effective, it must address both individual needs as well as support the social and community services that are required to meet these needs. The objective of this study is to adopt a place-based framework that combines: (1) individual-level referral for social needs, with (2) community and stakeholder engagement to determine community assets, resources, networks, and need to inform model development.</p><p><strong>Methods: </strong>The study will be conducted in three-phases across two low-socioeconomic Australian communities, underpinned by the 'enabling places' theoretical framework. Phase 1 will involve identifying key elements that enable place-based social prescribing using photovoice methods with health and social care providers and community members. Outcomes will inform co-design workshops to develop a place-based social prescribing model of care that is augmented by technology to facilitate integration across health, social, and community services. In Phase 2, the co-designed model will be implemented in the two communities. Phase 3 will involve a mixed methods approach to the evaluation of the model's implementation, effectiveness, and social return on investment.</p><p><strong>Discussion: </strong>The study aims to foster place-based initiatives and community development, a missing element in much of the social prescribing discourse. It is anticipated that outcomes will contribute to the design and implementation of social prescribing models that are tailor-made for Australian communities, systems, and funding systems.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"285"},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in the prescription of acute medical treatments in primary healthcare - comparison of the performance of family physicians and ChatGPT.","authors":"Bárbara Lemos Pereira Simão, Carolina Moura Pereira, Mariana Jácome, Catarina Oliveira, Laura Martins Ferreira, José Miguel Paiva, Carlos Braga, Carlos Seiça Cardoso","doi":"10.1186/s12875-025-02963-2","DOIUrl":"10.1186/s12875-025-02963-2","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) is increasingly being recognized as a transformative force in healthcare, showing significant promise in supporting healthcare professionals. AI has many applications in healthcare, including providing real-time decision support, diagnosing diseases, and advancing personalized medicine. However, clinical trials and further research are needed to evaluate the practical effectiveness of AI in primary healthcare.</p><p><strong>Objective of the study: </strong>This study aims to assess the accuracy of ChatGPT, an AI-powered chatbot, in therapeutic decision-making during acute disease consultations in primary care and compare its performance to that of general family physicians. The goal was to determine how well ChatGPT could replicate the decisions made by physicians based on standard clinical guidelines.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted at three primary healthcare units in the Central Region of Portugal. The analysis involved three phases: (1) collecting data from healthcare professionals, (2) gathering therapeutic proposals from ChatGPT v3.5 based on physician-defined diagnoses, and (3) comparing the treatments proposed by both ChatGPT v3.5 and the physicians, using the Dynamed platform as the gold standard for correct prescriptions.</p><p><strong>Results: </strong>Out of a total of 860 consultations, 138 were excluded due to non-compliance with the inclusion criteria. The analysis showed that the diagnostic accuracy of ChatGPT v3.5 and physicians co-occurred in 26.2% of cases. In 29.1% of cases, there was no agreement between the AI and the physicians' diagnoses. The therapeutic decisions made by ChatGPT v3.5 were correct in 55.6% of the cases, while physicians made correct decisions in 54.3% of the cases. The therapeutic decisions of ChatGPT v3.5 were incorrect in 5.2% of the cases, compared to 11% for physicians. Furthermore, the therapeutic proposals of ChatGPT v3.5 were 'approximate' to the correct treatment in 24% of the cases, while physicians had a 17.1% approximation rate.</p><p><strong>Conclusion: </strong>This study suggests that AI - specifically ChatGPT v3.5 - can match or even outperform physicians in terms of therapeutic decision accuracy, with a similar or slightly better success rate than human doctors. This highlights the potential for AI to act as an effective auxiliary tool rather than a replacement for healthcare professionals. AI is most effective when used in collaboration with healthcare professionals, augmenting their capabilities and improving overall healthcare delivery. Ultimately, AI can serve as a powerful aid to healthcare professionals, helping improve patient care and healthcare outcomes, particularly in primary care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"284"},"PeriodicalIF":2.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practitioners' involvement in inpatient medical rehabilitation in Germany: a scoping review.","authors":"Malte Klemmt, Katharina van Baal, Maria Bonin, Stephanie Stiel","doi":"10.1186/s12875-025-03007-5","DOIUrl":"10.1186/s12875-025-03007-5","url":null,"abstract":"<p><strong>Background: </strong>The German rehabilitation system has some peculiar features, such as the predominance of inpatient medical rehabilitation. Most patients receive inpatient rehabilitation due to chronic illnesses like chronic backpain or psychosomatic diseases. General practitioners play a special role in the German healthcare system as they are often the first point of contact for health issues. The study aims to provide an overview of the involvement of general practitioners in inpatient medical rehabilitation in Germany as well as identifying barriers and facilitators. By doing this, a basis for optimizing general practitioners' involvement can be generated.</p><p><strong>Methods: </strong>A scoping review was conducted to ascertain the current state of scientific knowledge, employing the methodological approach of the Joanna Briggs Institute. The search was carried out between February and March 2024. Eight databases were screened: PubMed, Web of Science Core Collection, PubPsych, EBSCOhost, BeLit, LIVIVO, ProQuest, and German National Library. Publications in German and English in the publication period from 1980 to February 2024 were sought. A thematic analysis was conducted to evaluate the included publications. The research process and generation of findings were recorded utilizing the PRISMA-ScR checklist.</p><p><strong>Results: </strong>The search resulted in a total of 2231 records, of which 102 were screened on a full text level. Fifty-four publications were included in the review. Following the thematic analysis, fourteen themes were identified and assigned to four topic areas. In the area of access, general practitioners take on a gatekeeper function (addressed by 10 publications) among other things. In follow-up care, there is involvement in prescription (5 publications), like referral to outpatient medical specialists. Barriers to involvement relate, for example, to a lack of knowledge on the part of general practitioners (10 publications) and facilitators include education and training (10 publications).</p><p><strong>Conclusions: </strong>The results confirm the important role of general practitioners in providing access to inpatient medical rehabilitation in Germany and follow-up care. However, various barriers for general practitioners' involvement were revealed. In order to maintain and optimize the involvement, further scientific research and efforts based on this in practice are necessary, involving relevant stakeholders.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"283"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia in primary care: a qualitative study with general practitioners and caregivers with and without migration backgrounds.","authors":"Nele Kornder, Nicole Lindner, Meinert Ehm, Felix Rachor, Cheng Wieli Shan, Stefan Bösner, Veronika van der Wardt","doi":"10.1186/s12875-025-02952-5","DOIUrl":"10.1186/s12875-025-02952-5","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"282"},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Health and Life in Balance intervention to improve patient capacity for older people with multimorbidity: a pragmatic mixed methods non-randomised pilot study.","authors":"Caroline Kappelin, Klas Ytterbrink Nordenskiöld, Elisabeth Bos Sparén, Annica Lagerin, Caroline Wachtler","doi":"10.1186/s12875-025-02974-z","DOIUrl":"10.1186/s12875-025-02974-z","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"279"},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and difficulties with providing child healthcare through team-based visits in child healthcare services - a focus group study.","authors":"Ulrika Svea Nygren, Leif Eriksson, Håkan Sandberg, Ylva Tindberg, Lena Nordgren","doi":"10.1186/s12875-025-02981-0","DOIUrl":"10.1186/s12875-025-02981-0","url":null,"abstract":"<p><strong>Background: </strong>The Swedish Child Healthcare services (CHS) includes team-based visits. Team-based visits are defined as physical meetings where different professionals, including the child and his or her parents, participate at the same time at the same place. This study aimed to explore healthcare professionals' experiences of these visits to better understand the opportunities and difficulties in meeting the unique needs of children and their families through team-based visits.</p><p><strong>Methods: </strong>An explorative qualitative design. Data were obtained through seven digital focus group interviews (FGDs) with 34 professionals within CHS, following the guidelines provided by Krueger and Casey.</p><p><strong>Results: </strong>All professional groups perceived great opportunities with team-based visits. Optimal team-based visits meant accessible and safe family support, based on children's and families' needs. Trustful relationships with someone in the team, can promote families' trust in the team, the assessment process, and healthcare organizations. For optimal team-based visits in CHS, professional competence, as well as organizational structures, are required. However, without enabling factors, here can be opposite effects on all those involved.</p><p><strong>Conclusions: </strong>Optimal team-based visits in CHS delivered in the right way, at the right time, by the right individuals can be an efficient and comprehensive way to meet the unique needs of children and families.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"280"},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supported in a time of need - first-time parents' perceptions of a Swedish extended home visiting program.","authors":"Maissa Al-Adhami, Katarina Garefalaki Kornaros, Gunilla Lönnberg","doi":"10.1186/s12875-025-02983-y","DOIUrl":"10.1186/s12875-025-02983-y","url":null,"abstract":"<p><strong>Background: </strong>Home visiting programs offer a way of delivering child health services to families that need them the most, based on socioeconomic and psychosocial conditions. Following evaluations of the implementation of a successful multiprofessional home visiting program in the Stockholm region, an extended version, Together for a safe start, was tested in four municipalities in the middle and southern parts of Sweden targeting first-time parents and immigrant parents having their first child in Sweden.</p><p><strong>Aim: </strong>To explore parents' perceptions of an extended Swedish home visiting program conducted by a nurse and a social service counselor.</p><p><strong>Methods: </strong>Interviews with 17 parents (12 mothers and 5 fathers) who had participated in the program were conducted. Among the 17 interviews, 11 were conducted in Swedish, 4 in Arabic and 2 in English by a multilingual interviewer. The data were coded inductively and analyzed using thematic analysis. The findings were discussed and validated with parents from the community who advised the research team.</p><p><strong>Results: </strong>Three main themes were identified, each with two subthemes (1). Trust was created in the comfort of the home, with the subthemes 'Home environment had many advantages', and 'Team's way of working created trust'; (2) The information on child health and development was valuable, with the subthemes 'Practical information and advice were useful' and 'Information on child development gave guidance'; and (3) Socioemotional support kept the parents' worries at bay, with the subthemes 'Mental well-being of the parents was cared for' and 'Parents felt supported in their new role'. Areas for improvement included mitigating the fear of social services, paying more attention to fathers' mental health and providing more written information.</p><p><strong>Conclusion: </strong>The home environment, adaptability to parents' needs, a combination of practical information on the child's development, and emotional support to parents were underscored as vital components of a successful home visiting program. The results reaffirm the potential of extended home visiting programs to increase trust and make child health services accessible, as well as bridge the gap between immigrant parents and societal services.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"281"},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}